Adherence in pediatric renal recipients and its effect on graft outcome, a single-center, retrospective study.
adherence
donor-specific antibodies
kidney transplantation
pediatric
rejection
Journal
Pediatric transplantation
ISSN: 1399-3046
Titre abrégé: Pediatr Transplant
Pays: Denmark
ID NLM: 9802574
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
revised:
11
10
2020
received:
04
08
2020
accepted:
27
10
2020
pubmed:
24
11
2020
medline:
24
4
2021
entrez:
23
11
2020
Statut:
ppublish
Résumé
In recent years, treatment-adherence gained increasing attention in nearly every area of medicine including transplant medicine. Medication adherence following solid organ transplantation is known to be indispensable for a satisfactory allograft survival. We examined 60 patients between the ages of four months and 20 years who underwent kidney transplantation at Hannover Medical School between January 2011 and August 2017. Age at transplantation varied from 4 months to 20 years. 12 patients (20%) already underwent their second solid organ transplantation. 5 patients (8.3%) had a combined kidney-liver-transplantation. We used two different methods for rating adherence: An objective one based on the coefficient of variation (CoV%) of immunosuppressant trough levels, and a subjective questionnaire answered by the patients themselves, their parents or legal custodians, the treating pediatrician, as well as by the attending psychologist. The CoV% in our study was by-trend higher in those patients who suffered from a biopsy-proven rejection (x̅ Apart from underlining the importance of medication adherence, the present research stresses the role of a multi-disciplinary treatment approach to support pediatric renal transplant recipients and their families.
Sections du résumé
BACKGROUND
In recent years, treatment-adherence gained increasing attention in nearly every area of medicine including transplant medicine. Medication adherence following solid organ transplantation is known to be indispensable for a satisfactory allograft survival.
METHODS
We examined 60 patients between the ages of four months and 20 years who underwent kidney transplantation at Hannover Medical School between January 2011 and August 2017. Age at transplantation varied from 4 months to 20 years. 12 patients (20%) already underwent their second solid organ transplantation. 5 patients (8.3%) had a combined kidney-liver-transplantation. We used two different methods for rating adherence: An objective one based on the coefficient of variation (CoV%) of immunosuppressant trough levels, and a subjective questionnaire answered by the patients themselves, their parents or legal custodians, the treating pediatrician, as well as by the attending psychologist.
RESULTS
The CoV% in our study was by-trend higher in those patients who suffered from a biopsy-proven rejection (x̅
CONCLUSIONS
Apart from underlining the importance of medication adherence, the present research stresses the role of a multi-disciplinary treatment approach to support pediatric renal transplant recipients and their families.
Substances chimiques
Tacrolimus
WM0HAQ4WNM
Types de publication
Journal Article
Comment
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13922Subventions
Organisme : Ministry of Education
ID : 01EO1302
Commentaires et corrections
Type : CommentOn
Informations de copyright
© 2020 The Authors. Pediatric Transplantation published by Wiley Periodicals LLC.
Références
Sabaté E, Stephen H, Burkhart P, et al. Adherence to long term therapies, Evidence for action. Geneva, Switzerland: WHO; 2003:3-5.
Petermann F. Patienmotivation und Compliance. In: Ehlebracht-König I (ed). Regensburg, Germany: S. Roderer Verlag; 2007:35-36.
Sandman L, Granger BB, Ekman I, Munthe C. Adherence, shared decision-making and patient autonomy. Med Health Care Philos. 2012;15:115-127.
Loghman-Adham M. Medication noncompliance in patients with chronic disease: issues in dialysis and renal transplantation. Am J Manag Care. 2003;9:155-171.
Siegal B, Greenstein S. Compliance and noncompliance in kidney transplant patients: cues for transplant coordinators. J Transpl Coord. 1999;9:104-108.
Didlake R, Dreyfus K, Kerman R, et al. Patient noncompliance: a major cause of late graft failure in cyclosporine-treated renal transplants. Transplant Proc. 1988;20(3 Suppl 3):63-69.
Sellarés J, de Freitas DG, Mengel M, et al. Understanding the causes of kidney transplant failure: The dominant role of antibody-mediated rejection and nonadherence: Attributing causes of kidney transplant loss. Am J Transplant. 2012;12:388-399.
Süsal C, Döhler B. Late intra-patient tacrolimus trough level variability as a major problem in kidney transplantation: A collaborative transplant study report. Am J Transplant. 2019;19:2805-2813.
Taddeo D, Egedy M, Frappier J. Adherence to treatment in adolescents. Paediatr Child Health. 2008;13(1):19-24.
Almeida AC, Leandro ME, Pereira MG. Adherence and glycemic control in adolescents with Type 1 Diabetes: The moderating role of age, gender, and family support. J Clin Psychol Med Settings. 2019.247-255.
Kreuzer M, Prüfe J, Oldhafer M, et al. Transitional care and adherence of adolescents and young adults after kidney transplantation in Germany and Austria: A binational observatory census within the TRANSNephro Trial. Medicine (Baltimore). 2015;94:e2196.
Thompson R, Nelson C. Developmental science and the media: Early brain development. Am Psychol 56(1), 5-15.
Pizzo HP, Ettenger RB, Gjertson DW, et al. Sirolimus and tacrolimus coefficient of variation is associated with rejection, donor-specific antibodies, and nonadherence. Pediatr Nephrol. 2016;31:2345-2352.
DeVos JM, Patel SJ, Burns KM, et al. De novo donor specific antibodies and patient outcomes in renal transplantation. Clin Transpl. 2011;351-358.
Everly MJ, Everly JJ, Arend LJ, et al. Reducing de novo donor-specific antibody levels during acute rejection diminishes renal allograft loss. Am J Transplant. 2009;9:1063-1071.
Roufosse C, Simmonds N, Clahsen-van Groningen M, et al. A 2018 Reference guide to the Banff classification of renal allograft pathology. Transplantation. 2018;102:1795-1814.
Brown C. Coefficient of variation. Applied Multivariate Statistics in Geohydrology and Related Sciences. Berlin, Heidelberg: Springer; 1998:155-157.
Rodrigo E, Segundo DS, Fernández-Fresnedo G, et al. Within-patient variability in tacrolimus blood levels predicts kidney graft loss and donor-specific antibody development. Transplantation. 2016;100:2479-2485.
Tönshoff B, Melk A, Höcker B. Immunosuppression in Pediatric Kidney Transplantation. Pediatric Kidney Disease. Berlin, Heidelberg: Springer; 2016.
Brunkhorst LC, Fichtner A, Höcker B, et al. Efficacy and safety of an everolimus- vs. a Mycophenolate mofetil-based regimen in pediatric renal transplant recipients. PLoS One. 2015;10:e0135439
Harambat J, van Stralen KJ, Schaefer F, et al. Disparities in policies, practices and rates of pediatric kidney transplantation in Europe: Pediatric kidney transplantation in Europe. Am J Transplant. 2013;13:2066-2074.
Shemesh E, Shneider BL, Savitzky JK, et al. Medication adherence in pediatric and adolescent liver transplant recipients. Pediatrics. 2004;113:825-832.
Pabst S, Bertram A, Zimmermann T, et al. Physician reported adherence to immunosuppressants in renal transplant patients: Prevalence, agreement, and correlates. J Psychosom Res. 2015;79:364-371.
Zeller A, Taegtmeyer A, Martina B, et al. Physicians’ ability to predict patients’ adherence to antihypertensive medication in primary care. Hypertens Res. 2008;31:1765-1771.
Kekale M, Airaksinen M, Porkka K, et al. Chronic myeloid leukemia patients’ adherence to peroral tyrosine kinase inhibitors compared with adherence as estimated by their physicians. Patient Prefer Adherence. 2014;1619
Cleemput I, Dobbels F. Measuring patient-reported outcomes in solid organ transplant recipients: An overview of instruments developed to date. Pharmacoeconomics. 2007;25:269-286.
Dobbels F, Berben L, De Geest S, et al. The psychometric properties and practicability of self-report instruments to identify medication nonadherence in adult transplant patients: A systematic review. Transplant J. 2010;90:205-219.
Thorndike E. A constant error in psychological rating. J Appl Psychol. 1920;4(1):25-29.
Neuwirt H, Rudnicki M, Schratzberger P, et al. Immunosuppression after renal transplantation. Memo - Mag Eur Med Oncol. 2019;12:216-221.
Oldhafer M. Transitionsmedizin, Multiprofessionelle Begleitung junger Erwachsener mit chronischer Krankheit. Stuttgart, Germany: Schattauer GmbH; 2016 pp 3-6; 85-86.
Verma T, Rohan J. Examination of transition readiness, medication adherence, and resilience in pediatric chronic illness populations: A pilot study. Int J Environ Res Public Health. 2020;17.
Ferris M, Cohen S, Haberman C, et al. Self-management and transition readiness assessment: development, reliability, and factor Structure of the STARx questionnaire. J Pediatr Nurs. 2015;30:691-699.
Hanish SI, Samaniego M, Mezrich JD, et al. Outcomes of simultaneous liver/kidney transplants are equivalent to kidney transplant alone: a preliminary report. Transplantation. 2010;90:52-60.
Ruiz R. Long-term analysis of combined liver and kidney transplantation at a single center. Arch Surg. 2006;141:735.